The concept of fractional photothermolysis revolutionized cutaneous laser resurfacing when introduced by Manstein et al in 2004. Using a nonablative, 1550-nm Er-doped fiber laser, full-thickness columns of thermal injury (termed microthermal treatment zones or MTZs) are created in a pixelated pattern just below the level of the stratum corneum, with the surrounding skin left intact. Because epidermal barrier function is intact, healing is rapid, without oozing or crusting. Patients typically require a series of treatments for the best response for a variety of conditions such as photodamage and atrophic scarring. However, with the deepest scars or rhytides, the amount of overall improvement may be marginal with this nonablative approach. A study has shown that multiple sessions are effective in facial rejuvenation, stimulating the formation of new collagen and resulting in better skin texture and finer wrinkles.